Analysis of factors influencing cognitive impairment and the predictive value of CD4+ T lymphocyte count in patients with HIV/AIDS

doi:10.19871/j.cnki.xfcrbzz.2026.04.006

Abstract

Abstract: Objective To investigate factors associated with cognitive impairment in patients with HIV/AIDS and to evaluate the discriminative performance of CD4⁺ T lymphocyte count for cognitive impairment, thereby providing evidence for the early clinical identification of individuals at high risk of cognitive impairment. Method A cross-sectional study was conducted. A total of 71 patients with HIV/AIDS who attended Chengdu Public Health Clinical Medical Center between January 1, 2024 and November 30, 2025 were enrolled. According to cognitive function assessment results, the patients were divided into a cognitively normal group (n=43) and a cognitive impairment group (n=28). General clinical data, sociodemographic characteristics, and laboratory indicators were collected from the hospital electronic medical record system, and quantitative brain structural imaging parameters were also obtained. Univariate analysis was performed to compare differences between the two groups. Based on the results of univariate analysis, statistical independence of variables, and clinical accessibility, a binary logistic regression model was constructed to identify independent factors associated with cognitive impairment. Receiver operating characteristic (ROC) curve analysis was further performed for significant variables to evaluate their discriminative performance. Result Univariate analysis showed that CD3⁺ T lymphocyte count and CD4⁺ T lymphocyte count were significantly lower in the cognitive impairment group than in the cognitively normal group (t=2.128,P=0.037; t= 6.044, P<0.01, respectively). Marital/partner status differed significantly between the two groups (χ²=6.303,P=0.012). Temporal lobe gray matter volume tended to be lower in the cognitive impairment group, and the difference was statistically significant in the uncorrected between-group comparison (t=2.114, P=0.038); however, the difference was no longer significant after false discovery rate correction. Binary logistic regression analysis showed that CD4⁺ T lymphocyte count (OR=0.987, 95%CI: 0.980-0.994, P<0.001) and marital/partner status (single vs. non-single: OR=5.702, 95%CI: 1.193-27.251, P=0.029) were significantly associated with cognitive impairment. ROC curve analysis indicated that CD4⁺ T lymphocyte count had good discriminative performance for cognitive impairment, with an area under the curve of 0.886 (95%CI: 0.812-0.961, P<0.001). At a cutoff value of approximately 260 cells/μl, the sensitivity was 93.0% and the specificity was 67.9%. Conclusion Decreased CD4⁺ T lymphocyte count and being single were the main factors associated with cognitive impairment in patients with HIV/AIDS. CD4⁺ T lymphocyte count demonstrated good screening value for cognitive impairment and may serve as a reference indicator for early identification of high-risk patients and follow-up management.

Key words: Human immunodeficiency virus, Acquired immunodeficiency syndrome, Cognitive impairment, CD4⁺T lymphocyte count, Structural magnetic resonance imaging of the brain, Predictive value

CLC Number:

R446

Xiong Lei, Zhang Shuying, Li Tao, He Jianglin, Lu Xiaoxi, Wan Ting, Xie Liqiu, Yang Jia, Gao Yueqin, Xiong Wei, Ge Yang, Wang Yin, Fu Siqi, Zhang Na, Hou Keke. Analysis of factors influencing cognitive impairment and the predictive value of CD4⁺ T lymphocyte count in patients with HIV/AIDS[J]. Electronic Journal of Emerging Infectious Diseases, 2026, 11(4): 36-43.

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Analysis of factors influencing cognitive impairment and the predictive value of CD4⁺ T lymphocyte count in patients with HIV/AIDS

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